BAMC Surprise Medical Billing:
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ightm N 1 l e A Lev
By Barry H. Beer
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anuary 27, 2017. It had grown dark and cold outside. Julius had places to go on his Harley Electra Glide. The weather was no deterrent for the twenty-five-year-old Army veteran. As he approached the 3600 block of Commercial Avenue in San Antonio, there were no vehicles ahead or behind him. The road was his own, as he liked it. Then, seemingly out of nowhere, a Ford Mustang came from the opposite direction and suddenly turned in front of him. There was no way to avoid the impact. It was devastating. Julius was rushed to the nearest Level 1 Trauma facility, Brooke Army Medical Center (BAMC), because the other such local facility, University Hospital, was farther away. He remained in a coma for seventeen days. He underwent multiple surgeries to reconstruct his face, skull, and shattered wrist. Countless pieces of titanium became permanent new skeletal fixtures. He was eventually discharged to live with his mother and start the agonizing process of recovery. He recalled nothing of the accident. Suffering from disabling pain and memory loss, Julius thought the worst was behind him. It was not. Months later, in the mail, a bill arrived from BAMC. It came from BAMC’s Uniform Business Office (UBO), and it read: “Balance due: $390,900.38.” The billing notices kept coming until in September, some eight months after hospitalization, he received this notice: This is the third and final attempt to collect your outstanding debt. Please be advised that your account balance is delinquent and referral to the US Department of Treasury is imminent. In accordance with the Debt Collection Improvement Act (DCIA) of 1996 and the Digital Accountability and Transparency Act (DATA), federal agencies are required to refer non-tax debts to the Department of Treasury within 120 days of delinquency. Neither the UBO nor the Military Treatment Facility where you received your services has the authority to grant a waiver to collect the charges related to these services. The UBO cannot assist you in obtaining a waiver and your debt cannot be placed on hold while you seek a waiver. You have the right to inspect and copy government records related to these charges and request a review of how we determine your charges; however, this request does not alleviate your financial responsibility. 14 San Antonio Lawyer® | sabar.org
Julius had no means to even begin to pay such a large debt. By the summer of 2019, he was again employed, though very much still recovering from his injuries from the accident two years earlier. On July 30, 2019, Julius received a letter from Coast Professional, Inc., entitled “Notice of Intent to Initiate Administrative Wage Garnishment Proceedings.” It read: This notice is from Coast Professional, Inc., a private collection agency on behalf of the US Department of Treasury, Bureau of Fiscal Service. Fiscal Service, the current holder of your outstanding delinquent federal obligation, on behalf of Department of Defense, has placed your account with the agency for collection. The current balance listed above, as due and owed, may be accruing daily interest and penalties, the actual amount owed may be different than what is stated. Julius stared for minutes at the notice from the collection agency, fixated and motionless. In the top right corner, next to the account number it read: “Current balance due: $632,307.56.” Due to penalties, costs, fees, and interest, his original principal balance had nearly doubled. As an honorably discharged veteran, he wondered why the VA would not pay for his medical services at BAMC. He soon discovered that, because he had neglected to enroll with the VA system upon his discharge, he was not qualified to have the VA pay his bill. He was told that—other than active military or a retiree or covered family member—all other civilians were responsible for full health care billing. For BAMC billing purposes, he was a civilian. Julius had no private health insurance on his own. The driver of the Mustang maintained only minimum insurance limits of $30,000, and the settlement tender of the injury claim did not even make a dent in Julius’s bill. Adding insult to already horrific injuries, within weeks of Coastal’s garnishment warning letter, Julius watched his paycheck being docked, with thousands of dollars quickly being stripped away. Because of fees and penalties, the balance due continued to rise, despite multiple garnishment payments. He would certainly die still owing the lion’s share of the debt, he thought to himself. To make matters worse, the debt was destroying his credit. He was unable to move out of his mother’s house and purchase his own home,
